The 'Loudest, Most Crunchy, Neck Popping, Back Cracking' Blog Ever!

Have you ever been on YouTube and searched “chiropractic adjustment”? The videos posted on the site will tout about how they are the “loudest, most crunchy, neck popping, back cracking adjustments ever!” As a parent myself, I can see why you would be very cautious about bringing your child to a chiropractor if that was the expectation.  I used to have videos on YouTube showing off my adjustments, but I took them down. Not because they were offensive or dangerous, I didn’t want my specific, proper adjustments to be lumped in the same category as the other videos on there. From a layman's perspective, they might both look the same, but they couldn’t be more different. 

A large percentage of the “adjustments” you see on YouTube are very far off from what is considered an adjustment, especially a specific adjustment. All the twisting, cracking, and popping that goes on in those videos are aimed at one thing and one thing only, viewership. And to create views, you need to sell “crack.” By “crack” I mean you try and create as much noise as possible. People will actually edit their videos to enhance the “cracking” noise. Those videos in my opinion not only manipulate the adjustment from a physical standpoint, but on a psychological standpoint as well.  

The noise sometimes heard during an adjustment is called a cavitation. A cavitation is a normal occurring event that can take place during an adjustment. While the exact mechanism for a cavitation occurring in a joint is unclear, the supporting theories all involve pressure and carbon dioxide. Inside a joint, bubbles of carbon dioxide are created due to a rapid change of pressure. Different studies show that the gas bubbles will either collapse on themselves or release out into the synovial fluid to only be absorbed back into the joint. In either case, the bubbles create the “popping” sound. If you have ever “popped” or “cracked” your knuckles, the same overarching theory of the cavitation occurs. 

To create those loud and drawn out cavitations, you need to manipulate many joints at one time. This requires putting joints beyond their physiological range of motion. This is where you will see all the twisting, wrenching, pulling, pushing and yanking actions. Where it looks like they make a pretzel out of the patient. To obtain the multiple cracking effect, you have to move more than one vertebra at a time. That is where the “bubble wrap popping” effect comes into play. Which is not an adjustment, but a manipulation. 

A cavitation itself is harmless, but the sound can be surprising. And often when we get surprised, that split second of the unknown can elicit different responses. Our brains are hardwired to respond to that uncertainty on an emotional level. Those “adjustment” videos play on our emotions of suspense. It should be no surprise that the suspense genre, is dotted throughout the entertainment industry and is found across all platforms. Whether it is a haunted hayride, mystery novel, dramatic TV series, or sensationalized chiropractic adjustment videos, we all are drawn to some form of suspense. 

An adjustment is a controlled force, employing leverage, direction, amplitude and velocity. It is applied to a specific vertebra for the purpose of correcting a vertebral subluxation. That is an important definition, but extra consideration needs to be put on the phrase “specific vertebra”. Which defines a singular spinal bone, not plural spinal bones. Also for a proper adjustment to occur the patient should be supported in a static position. Simply put: If you need to move the patient to move the bone, too much force is at play. I seem to be using wine analogies a lot lately, but I think this one fits perfectly. The simplest and easiest way to open a bottle of wine is with a corkscrew. This is where the bottle is held in a static position and using a specific force, leverage, direction, amplitude and velocity, the corkscrew easily and quickly removes the cork. But a search on YouTube will show you many different and crazy ways to open the bottle without a corkscrew. One in particular, requires a shoe and a wall. The “hack” involves you placing the wine bottle in the heel portion of the shoe, cork side out. Then with all your might, you bang the shoe against a wall repeatedly until the cork slowly comes out. I hope it is easy to see which of the two methods is an adjustment and which one is a manipulation. Also, which video do you think would receive more viewership: one where a bottle of wine is opened with a corkscrew or one that is opened with a shoe? The same principle occurs with videos that have the “loudest, most crunchy, neck popping, back cracking manipulations ever!”

How much force is applied to a spine during an adjustment? Accurately quantifying each and every adjustment can be a challenge but some studies do help put the adjustment force into comparative relation. Some of the more well researched studies put the force in terms of Newtons. A Newton is the International System of Units determined unit of force. One Newton is defined as the force needed to accelerate one kilogram of mass at the rate of one metre per second squared in the direction of the applied force. 100 Newtons is about equivalent to 22.5 lbs of force.

One study that measured the force of an adjustment on the pediatric population follows as such:

  • Neonates and infants aged 0 to 2 months: 20 Newtons of force was used.

  • Infants and toddlers aged 3 months to 23 months: 28 N

  • Young children aged 2 years to 8 years: 60 N

  • Older children and young adults aged 8 to 18 years: 88 N

To put those numbers into perspective, a study that looked at the force used during the medical birthing process follows as such:

  • Intrauterine pressure: 16 N. This pressure measure the muscles of the uterus and their normal tone at rest. Even when a muscle is not fully contracted, it still maintains some tautness for integrity purposes. 

  • Uterine contraction: 54 N. This contraction occurs naturally without conscious influence.  

  • Volitional push: 120 N. This is when the mother actively bares down and pushes.

  • Vacuum device traction: 113 N. A vacuum traction is typically done 4 times during each contraction and push. So during a normal vaginal birth; which includes the intrauterine pressure, uterine contraction and volitional push, the force can add up to 190 N. When you add a vacuum device to the equation, the force can add up to 303 N

  • Obstetric forceps traction: 200 N. If we add that to the normal vaginal forces, the number jumps up to 390 N

Another study looked at the forces of obstetrical traction, testing the tensile strength of the spinal column. 

  • Cervical traction to point of dislocation of the cervical spine: 400 N

  • Cervical traction to point of decapitation: 533 N

And finally, one another study looked at the force needed to fracture the pedicles of a cervical bone.

  • Fracture of the cervical spine: 3,200 N

No force of a specific adjustment could ever come close to a dislocation or fracture, two untruths that sometimes circulate around Chiropractic objectors. Chiropractic has had its fair share of scrutiny and condemnation over its 120 plus year history. Fake news is nothing new to Chiropractic. Fallacies that the Chiropractic adjustment is unsafe and/or harmful is usually the biggest contention from mainstream medicine. These claims are not based on any real scientific measures though and are rooted more in misconceptions, archaic bias and ignorance. I will say that the chiropractors who post those ill-conceived adjustment videos are only fueling the fire of these negative claims.

An adjustment is not only specific in terms of physics, but also specific to each person. The adjustment I give to your 3 month old baby is not the same adjustment I give to a 33 year old adult. Furthermore, the adjustment I give to your 3 month old baby is not the same adjustment I give to another 3 month old baby. Children are not “small adults” and their adjustments shouldn’t be thought of in those terms. The care of a child’s spine is different than the care of an adult’s spine. The specificity of an adjustment is just that: unique and tailored for each individual. Children deserve special care and attention. Their spines and nervous system are unique. 

- Jarek Esarco, D.C.

Dr. Jarek Esarco is a pediatric and family wellness Chiropractor. He is an active member of the International Chiropractic Pediatric Association (ICPA). The ICPA is an organization of chiropractic family practitioners dedicated to advancing public awareness and the family wellness lifestyle. Dr. Jarek also has post-graduate certification in the HIO Specific Brain Stem Procedure technique through The TIC Institute. Dr. Jarek is happily married to his wife Regina. They live in Youngstown, Ohio with their daughter Ruby.

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